Our study confirms elevated lipoprotein(a) level is an independent predictable risk factor for future development of new onset diabetic retinopathy in type 2 diabetes.

A well-controlled glycemic group (mean HbA_1c <7.0%) developed DR by less than half compared to the poorly glycemic-controlled group (mean HbA_1c >9.0%) during the study period.

Patients with the highest Lp(a) quartile concentration in type 2 diabetes had an increased risk for developing DR.

Even if the mean HbA_1c level was <7.0% during the observation period, the highest Lp(a) quartile group showed significantly increased risk for developing DR.